Counseling Patients To Quit

Effective smoking cessation counseling can be divided into practical and supportive counseling advice.

Practical counseling advice (problem-solving/skills training)

Recognize danger situations.
Identify events, internal states, or activities that increase the risk of smoking or relapse.

Examples

  • Negative affect.
  • Being around other smokers.
  • Drinking alcohol.
  • Experiencing urges.
  • Being under time pressure.

Develop coping skills.
Identify and practice coping or problem-solving skills. Typically, these skills are intended to cope with danger situations.

Examples

  • Learning to anticipate and avoid temptation.
  • Learning cognitive strategies that will reduce negative moods.
  • Accomplishing lifestyle changes that reduce stress, improve quality of life, or produce pleasure.
  • Learning cognitive and behavioral activities to cope with smoking urges (e.g., distracting attention).

Provide basic information.
Provide basic information about smoking and successful quitting.

Examples

  • Any smoking (even a single puff) increases the likelihood of full relapse.
  • Withdrawal typically peaks within 1-3 weeks after quitting.
  • Withdrawal symptoms include negative mood, urges to smoke, and difficulty concentrating.
  • Smoking is addictive.

Supportive counseling advice

Encourage the patient in the quit attempt.

Examples

  • Communicate belief in the patient's ability to quit.
  • Note that effective tobacco dependence treatments are now available.
  • Note that half of all people who have ever smoked have now quit.

Communicate caring and concern.

Examples

  • Ask how the patient feels about quitting.
  • Directly express concern and willingness to help.
  • Be open to the patient's expression of fears of quitting, difficulties experienced, and ambivalent feelings.

Encourage the patient to talk about the quitting process.

Examples

Ask about:

  • Reasons the patient wants to quit.
  • Concerns or worries about quitting.
  • Success the patient has achieved.
  • Difficulties encountered while quitting.
Current as of December 2012
Internet Citation: Counseling Patients To Quit. December 2012. Agency for Healthcare Research and Quality, Rockville, MD. http://www.ahrq.gov/professionals/clinicians-providers/guidelines-recommendations/tobacco/counsel.html